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Suggest Treatment For Symptoms Of Hypothyroidism
Question: Dr. Rynne,
I was formerly on a thyroid supplement from 1997 to 2002. I was removed from the thyroid supplement while on a ventilator and have never been put back on the supplement. My family physician has run a TSH twice and it has come back normal, but I am suffering from a multitude of hypothyroidism symptoms over a page long. l can hardly put one foot in front of the other. What do you suggest?
I was formerly on a thyroid supplement from 1997 to 2002. I was removed from the thyroid supplement while on a ventilator and have never been put back on the supplement. My family physician has run a TSH twice and it has come back normal, but I am suffering from a multitude of hypothyroidism symptoms over a page long. l can hardly put one foot in front of the other. What do you suggest?
Brief Answer:
Please do a full thyroid profile
Detailed Answer:
Good day,
Welcome to healthcare magic. Noted your concern.
There are 2 types of hypothyroidism. Primary and secondary. In primary hypothyroidism, the TSH will be high and Free T4 will be low. Where as in secondary hypothyroidism, Free T4 will be low, but TSH will be normal or low. Hence, your family physician should run a full thyroid blood profile ( TSH and Free T4) to get a more realistic picture. It is usual for primary care doctors to just do TSH and if normal, assume that thyroid is normal. In doing so, secondary hypothyroidism will be missed. In your case, it is prudent to do both TSH and Free T4 ( FT4).
Regards
Binu
Please do a full thyroid profile
Detailed Answer:
Good day,
Welcome to healthcare magic. Noted your concern.
There are 2 types of hypothyroidism. Primary and secondary. In primary hypothyroidism, the TSH will be high and Free T4 will be low. Where as in secondary hypothyroidism, Free T4 will be low, but TSH will be normal or low. Hence, your family physician should run a full thyroid blood profile ( TSH and Free T4) to get a more realistic picture. It is usual for primary care doctors to just do TSH and if normal, assume that thyroid is normal. In doing so, secondary hypothyroidism will be missed. In your case, it is prudent to do both TSH and Free T4 ( FT4).
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I read a report on a website dealing especially with hypothyroidism. XXXXXXX Romm, M.D. suggested that the following tests be run. What is your opinion?
The tests were as follows: TSH; T3; T4; Reverse T3;TPOAb; TgAB
The tests were as follows: TSH; T3; T4; Reverse T3;TPOAb; TgAB
Brief Answer:
Reverse T3 may not be necessary
Detailed Answer:
Thank you for the reply. I agree that, TSH, Free T4 are required. TPO antibody and Tg antibody are good to know if you have auto immune hypothyroidism. Reverse T3 is seldom required. It is rarely done to rule out sick euthyroid state.
Regards
Binu
Reverse T3 may not be necessary
Detailed Answer:
Thank you for the reply. I agree that, TSH, Free T4 are required. TPO antibody and Tg antibody are good to know if you have auto immune hypothyroidism. Reverse T3 is seldom required. It is rarely done to rule out sick euthyroid state.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Binu:
I have the following symptoms, are there any other tests I need to request? And am I under the correct impression that once diagnosed with hypothyroidism and medicated for it that I should have never been taken off of the thyroid supplement?
Symptoms:
Facial skin feels thinner
My muscles feel weak, especially upper arms and thighs.
Insomnia
Exhausted all the time, feel as if I can hardly sit up.
Unable to tolerate exercise.
Less stamina and energy than others.
Hair is falling out.
Skin is dry and scaly.
Constipation.
Depressed when not medicated.
Joint aches and pains, lower back pain.
Feel restless, anxious and severe panic attacks with medication.
Moods change easily.
I have difficulty focusing and concentrating even though I am on Ritalin.
Losing interest in normal daily activities. Don't have energy to participate.
Forgetful and period of total memory loss.
No sex drive.
Eyes feel gritty and dry. Sensitive to light.
Trouble swallowing with a feeling of lump in throat,
Have a hoarse, gravelly voice.
Have tinnitus in my ears.
Some lightheadedness and dizziness.
Infertility - 4 miscarriages 20-25 years ago; had elevated prolactin at time, when treated with Parlodel was able to carry baby to term.
No periods.
Iron deficiency
Frequent headaches
Family history:
Mother had hypothyroidism
Mother had MS
Mother had congestive heart failure.
Father had congestive heart failure.
Father had Coronary Artery disease
Thank you for your input.
XXXX
I have the following symptoms, are there any other tests I need to request? And am I under the correct impression that once diagnosed with hypothyroidism and medicated for it that I should have never been taken off of the thyroid supplement?
Symptoms:
Facial skin feels thinner
My muscles feel weak, especially upper arms and thighs.
Insomnia
Exhausted all the time, feel as if I can hardly sit up.
Unable to tolerate exercise.
Less stamina and energy than others.
Hair is falling out.
Skin is dry and scaly.
Constipation.
Depressed when not medicated.
Joint aches and pains, lower back pain.
Feel restless, anxious and severe panic attacks with medication.
Moods change easily.
I have difficulty focusing and concentrating even though I am on Ritalin.
Losing interest in normal daily activities. Don't have energy to participate.
Forgetful and period of total memory loss.
No sex drive.
Eyes feel gritty and dry. Sensitive to light.
Trouble swallowing with a feeling of lump in throat,
Have a hoarse, gravelly voice.
Have tinnitus in my ears.
Some lightheadedness and dizziness.
Infertility - 4 miscarriages 20-25 years ago; had elevated prolactin at time, when treated with Parlodel was able to carry baby to term.
No periods.
Iron deficiency
Frequent headaches
Family history:
Mother had hypothyroidism
Mother had MS
Mother had congestive heart failure.
Father had congestive heart failure.
Father had Coronary Artery disease
Thank you for your input.
XXXX
Brief Answer:
Hypothyroidism is usually permanent
Detailed Answer:
Good day,
It was quite late in the night yesterday here when I answered your question and hence the delay. My sincere apologies.
Noted your symptoms. Some of the symptoms may be hypothyroidism related. Most symptoms of hypothyroidism are non specific and hence, it can also occur in other diseases.
Do you also suffer from Depression/anxiety or have you had these any time in the past??
Occasionally, in transient hypothyroidism, thyroid functions improve spontaneously and we may be able to stop the thyroxine replacement.
However, as you correctly pointed out, in most cases of hypothyroidism, we may have to continue medicine life long, especially if you have a positive family history.
On your next blood test, please get a Free T4, TSH, Anti TPO, Thyroglobulin antibody. This will give us more clarity.
Besides, it is a good idea to get Vitamin B12 and Vitamin D levels done.
Hypothyroidism is usually permanent
Detailed Answer:
Good day,
It was quite late in the night yesterday here when I answered your question and hence the delay. My sincere apologies.
Noted your symptoms. Some of the symptoms may be hypothyroidism related. Most symptoms of hypothyroidism are non specific and hence, it can also occur in other diseases.
Do you also suffer from Depression/anxiety or have you had these any time in the past??
Occasionally, in transient hypothyroidism, thyroid functions improve spontaneously and we may be able to stop the thyroxine replacement.
However, as you correctly pointed out, in most cases of hypothyroidism, we may have to continue medicine life long, especially if you have a positive family history.
On your next blood test, please get a Free T4, TSH, Anti TPO, Thyroglobulin antibody. This will give us more clarity.
Besides, it is a good idea to get Vitamin B12 and Vitamin D levels done.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry for the delay in answering your question. I do suffer and have suffered from severe anxiety, panic attacks and severe depression. Am medicated for both. The anxiety is not managed by large dose of Xanax. Depression is well managed with Effexor 150mg 3 in am, and Geodon 80mg two at bedtime....Have spells where I begin shaking violently, heart palpitations and flushing, very anxious when I've had nothing to cause a panic attack. These two situations were well managed before the thyroid was stopped, but have been very difficult to manage since it was stopped. I do see a psychiatrist for management of these difficulties.
Brief Answer:
Transient thyroid abnormality of Depression
Detailed Answer:
Thank you for the reply. Sorry to say, but i feel anxiety and depression seems to play a great role in most of your symptoms rather than hypothyroidism . Please be aware that, anti depressant medications and depression itself can cause fluctuation in thyroid blood works from time to time.
I suspec,t that was the case with you when the thyroid blood works showed some abnormality during an epidose of a bout of depression and the doctor erroneously put you on thyroid hormones thinking that you had hypothyroidism. It is not proper to check thyroid levels unless there is a strong suspicion. Many such people are labelled as having hypothyroidism.
Please meet your psychiatrist and pyschologist and they need to address many of your SOMATIC symptoms.
Transient thyroid abnormality of Depression
Detailed Answer:
Thank you for the reply. Sorry to say, but i feel anxiety and depression seems to play a great role in most of your symptoms rather than hypothyroidism . Please be aware that, anti depressant medications and depression itself can cause fluctuation in thyroid blood works from time to time.
I suspec,t that was the case with you when the thyroid blood works showed some abnormality during an epidose of a bout of depression and the doctor erroneously put you on thyroid hormones thinking that you had hypothyroidism. It is not proper to check thyroid levels unless there is a strong suspicion. Many such people are labelled as having hypothyroidism.
Please meet your psychiatrist and pyschologist and they need to address many of your SOMATIC symptoms.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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